Background: Male hypogonadism is associated with reduction in bone mineral density (BMD). This study aimed to determine the epidemiology of low BMD in a clinic-based cohort of hypogonadal men.

Methods: This was a retrospective, cross-sectional observational study of 152 patients (≥18 years with testosterone(T) ≤11 nmol/L) who were consequently reviewed in an endocrine clinic. Data was extracted from electronic patient records and included baseline characteristics, biochemical parameters and details of BMD.

Results: Of the 152 hypogonadal patients 68(45.3%) had a DEXA scan, of whom 36(52.9%) had osteopenia and 14(20.6%) had osteoporosis. There was a high prevalence of osteopenia and osteoporosis among all age categories {<40 years (70%); 4160 yrs (70%) & >61 years (83.4%)}. Nine (50%) primary hypogonadal patients had osteopenia and 5 (28%) had osteoporosis. Among patients with secondary hypogonadism 24(52%) had osteopenia and 8(17%) had osteoporosis. There was significant difference in T levels between patients with normal BMD and those with osteopenia and osteoporosis (6.9 vs 5.3 nmol/L; P=0.008) but not between patients with osteopenia and osteoporosis. Men with osteopenia and osteoporosis weighted less (91.4 vs 110 kg), used more prescribed medications (5.6 vs 4.6), had more comorbidities (4.0 vs 3.5), and had higher proportion of current and exsmoker (51 vs 26.3%) than hypogonadal patients with normal BMD.

Conclusion: Measurement of BMD should be considered in all hypogonadal men (even among hypogonadal men <40 years) as there is a high prevalence of osteopenia and osteoporosis among these patients.

Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.